F.E.A.S.T's Around The Dinner Table forum

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sandie
Hi. Don't think there is a right answer to this. What would you do?
D has started new ED behaviour in last week insisting that her cereal is ground to be more powdery in the morning. I cannot believe I got drawn into this before realising it was ED. I think it makes it look smaller/ needs less milk. So i decided that i wasn't going to do anymore from this morning and had an alternative cereal available as contingency. And planned not to allow her go to school if didn't eat breakfast ( as she wants to go to school). Basically she trashed kitchen and ground her own cereal. I remained calm, told her behaviour was not acceptable and said she had to clean the mess before she went to school. She very bad temperedly and aggressively did some tokenistic cleaning up and I let her go. I have significant behavioural issues with her at present which i am trying to address. My query is really about eradicating the ED behaviour about grinding cereal. Should i just try again tomorrow? She may just continue to grind cereal herself or should i just get rid of that particular cereal? It is a "good" calorific cereal. Answers on a postcard!!! Xxx
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scaredmom
I think that is ED. If she cannot  have regular cereal then no cereal and you get to choose what she has. And I would get rid of that cereal to make sure it cannot be an issue.

 Ha!! What easy sentences to write what a hard thing to accomplish.
The difficult behaviour needs to stop and I am glad you made her clean up her mess a bit. 
Parenting these kids is so hard. First trying to get them to eat, deal with behaviours that are outrageous , finding the stamina to keep up with all of that really is heavy task.

When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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Foodsupport_AUS
Hi Sandie, it really is like playing whack a mole. You get one down and up pops the next one. Well done on setting consequences for the mess, and no school. It is all so exhausting. 

Your question of course is not does this need to stop, but rather which way to go about it. I think not using the cereal for a bit may be a good way to start addressing rewiring behaviour. Using something else calorific and hopefully compact may shift the focus enough that when the cereal comes back she isn't doing the same thing. Other options are serving the cereal as you expect it to be eaten, including milk. If she is crushing it you could introduce a time limit, you could let her know that she is not to crush it and if required she will need something added. You could switch out the cereal completely. 
Another sneaky option is to go ahead and enthusiastically grind her cereal and add then almond meal, though I think allowing ED to even think it is having a win for a bit is a bad idea. 
D diagnosed restrictive AN June 2010 age 13.5. Weight restored July 2012. Relapse and now clawing our way back. Treatment: multiple hospitalisations and individual and family therapy.
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sandie
Thanks both, i was already adding ground almond to this cereal so irritating that it has come to this. Behaviour very defiant at the moment. I think best to dump this cereal for now to prevent further wiring.
Might try pancakes tomorrow.........thanks again. So great to have listening ears for these dilemnas!!!!!
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tina72
I think we have to eliminate ALL that seems to be rigid and an ED rule in any way. That can mean "same cereal every day" or "special bowl every day" or "snack is to serve at 4 p.m. and not one minute earlier or later" - what ever it is, if it is obviously an ED rule then break it. And if it is needed to dump that cereal or to break that bowl or to put down all clocks in the house then DO IT.
Keep feeding. There is light at the end of the tunnel.
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debra18
My daughter blended her supper in the early days of referring. I used it to my advantage and could blend in oil and nuts this way. One day she stopped this mush into her library books and destroyed the books. She paid for the books and never blended her food again. My opinion is it's most important to get in the calories and get the weight on. If you think you can get her to eat the pancakes instead than give it a try. But in my experience I only stopped behaviors that prevented wright gain (hiding pancakes in her pocket and crumbs in napkins). The other behaviors went away on their own with more weight. It's not worth it if she will start refusing meals.
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WeRnotdone
Hi Sandie,
  The great cereal debate. My daughter also struggles with cereal. Before I fully understood all the Ed behaviors I tried to help her with this. The ratio from cereal to silk had be be just right then the cereal had to turn mushy. I would repour cereal over, one morning I lost my cool she was grabbing the cereal bowl and would not let go. I slammed the bowl on the counter and broken bowl and cereal all over the kitchen. It was a turning point. After that she was not allowed in kitchen when I got her cereal or any food. She had to eat her food or we were sending her to a treatment center. That turned her around and got her out of her 1st relapse. Now she eats a breakfast sandwich instead. Still has a problem with cereal but I am better at staying calm and not losing my cool.
   In fact, she is coming out of her second relapse. She has gained the past two weeks and yesterday she told me I am saving her life. OMG I had to try not to start balling. She still has a lot of work to do but there is light at the end of the tunnel. Hang in there.😊
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Yogi13
sandie,
I am so new to this, but from what I see, you need to go through the behavior to eradicate it.  I admire your calm.  My daughter's newest struggle is time-it's too late to eat, mom.  She's babysitting now (7:30 here in NY).  I am giving her a shake when she gets home.  I may be wearing it-wish me luck.  As hard as this is (and I have had an extremely difficult day, the sun rises tomorrow and it is a new day).  Keep marching on.  
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sandie
Thanks all for sharing,
@tina72 yes I agree, i think it was probably time to increase variability of breakfast anyway although on the otherhand my other D has eaten the same breakfast cerea for years! But totally get your point about avoiding rigidity.
@debra18 I get your point about focus on getting calories in. At current stage, my priority has slightly shifted at the moment to food variety, behavioural management and trying to help her build a better life.

@WeRnotdone what a special thing to hear your daughter say. I am sure that will waft you along for quite sometime through all the challenges!
@Yogi13 hope that shake went down the right way.

Similar incident this morning which was a bit more violent. Although eventually ate a different cereal as was going on school-outing with friend.i will need to try to set some rules tonight and set out what will happen around breakfast as both mornings, she has been full of uncontrollable rage. Really worrying
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tina72
Uncontrollable rages are nothing you can and need to accept. Would it help to refuse school if that happens again?
Keep feeding. There is light at the end of the tunnel.
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sandie
She is full of rage. It will happen again. I have asked for psych review in case meds might help. I feel a bit overwhelmed today and uncertain but trying to plot way forward.
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scaredmom
I stand with you right now, shoulder to shoulder, mothers in arms fighting ED! 
🤗
Asking about meds is a plan forward. 
The fact is she ate the other cereal! She did not go out without eating! I call that two wins.
i know it shakes you to your core. Hang in there. 
When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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Yogi13
The meds have really helped my d with her rages.   Good luck.  You’ve got this! 
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sandie
Thanks for your support. Meant a lot last night and good to know meds helped your D's rages Yogi.
D on hunger strike now since dinner last night( 19 hours) holding out for Alpen( the cereal I discarded). I remain calm. I know advice is to bring to a and e if they have not drunk for 24 hours. I have not had to do before and hope i don't have to follow through with it. Not sure if it is ED I am dealing with now or just D's temper/stubborn nature.
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tina72
It is probably both 🙂.

Please do take her to A&E if she refuses food and drinks for more than 24 hours and if any possible take the doctor to a 4 eyes conversation first and tell him to tell your d that she needs to eat now and all that you serve. Worst thing would be to be send away and they say she is o.k. with no food and drinks (these things happen in the AN world).

Take food with you to A&E, some eat suddenly on the hospital car park or in hospital if they are scared.
Keep feeding. There is light at the end of the tunnel.
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Ellesmum
Agree with Tina, if you do go take a ‘hospital picnic’ you could have a long wait and definitely try to get word to a doctor to make food a  medical order. I’ve done this by ‘checking the waiting times’ before now, most doctors have had the wit to follow my cues and madly talkative eyes.  (Apart from a couple of male doctors who clearly thought I was crazy with me trying to signal them and prod them into saying helpful things) 
Ellesmum
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scaredmom

For what it is worth, I think her stand off is 100% ED. A child without ED would get hungry and eat anyway if you wait long enough.

Here are some guidelines to take with you if you need to go to the emergency room
http://www.nyeatingdisorders.org/pdf/AED%20Medical%20Management%20Guide%203rd%20Edition.pdf

What I found very useful, was that we had a note from our ED pediatrician who has privileges and works out of our closest hospital in case we presented to the ER. In that note her diagnosis was noted, and  it was outlined by which criteria  to admit  and then the procedure was to call her or the other peds on call to admit. We did not need it, but I remember having to get her stitches in the first few weeks of refeeding and the nurse in triage did know that she had to be blind weighed. 

I think if you take her, whether or not she gets admitted, it is a shock to ED that you actually DID take her. And that is priceless, to actually take the drastic step, take her to the hospital. ED knows that you will not take this lying down. There a few lessons there, she has to eat, you will call her out on it and others may need to get involved- all of those can be motivating and she will remember the next time,  and maybe there will not be next time because you took control now.
And it will make you stronger for sure. 
All the best,

When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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scaredmom
Hi sandie, I do hope she ate yesterday and that she is eating properly for you today.
Sending my best,
When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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sandie
Thanks. I eventually got her to eat bowl of pasta late last night thankfully. We had told her we were taking her to A and E and she got highly agitated and violent. There is no way we could have taken her without police support or something. Today, i took her on outing to try to change the atmosphere. Eating has been ok although ED strong and she is highly irritable and getting agitated about dinner. We have long road ahead of us! I will get onto cahms service to try to speed up psych review. Thanks for asking. I really value your support.
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scaredmom
It must have been quite frightening! I am sorry for that. 
I hope the psychiatric evaluation is soon. 
Sending strength,
When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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sammspiess
Go to the store, buy cereal that your daughter has never heard of, put it in a container throw the box away that way she won’t know the name of the cereal to even look up the calories. Tell her no school if no breakfast. No negotiations and she must eat a portion you are portioning until she is able to do it herself again. She will fight and scream but you must be stronger. You have a body that can be put in front of a door if she tries to leave, you have the power to fix this problem 
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sandie
Update- she had psych evaluation last week and it was decided she would benefit from SSRI as has all symptoms of childhood depression.
Frustratingly psychiatrist now gone on 3 weeks holidays so she cannot start till after as there are no cover arrangements. I am not sure how we will manage until then. The main problem is unpredictable high agitation which may not be related to food in first instance and where she becomes physically aggressive towards me. This inevitably also causes food refusal and means it is extremely difficult to challenge ED. We have 2 bouts in last few days.
We have just confiscated her phone due to violence. I hope that has impact.
i am trying to keep her active to help her mood. Swimming was really effective on Friday. I thought i was going to have to ring crisis team due to high agitation and i asked her if she would like to go for swim ( for 1st time in 7 months or so) and managed to calm her down.
i kept her busy over weekend and she was reasonably ok. But yesterday evening she just went ballistic again.
She sees psychologist weekly but i am worried that the psychologist undemines me with her approach and has discussions with ED. Eg psychologist called me into.meeting last week and asked did I agree that perhaps on the reasons things become difficult is that D and I are very similar and don't want to back down from our positions. This was in relation to the bloody Alpen. Psychologist then wanted a discussion about how D could achieve same texture without grinding Alpen. This seems so wrong to me. I emailed her afterwards to say poitely there was a risk that this was negotiating with ED but we seem to be on different wavelengths nd i don't feel she is supporting FBT principles. 

so frustrating and worrying. I feel i could better support my D's recovery with better support from the service but don't feel i could do it without them.
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sandie
Update on my update- managed to get another psychiatrist review for this week with dr covering ( altho they said there was no cover last week). Relieved....
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scaredmom
I am glad there is another doctor around . Honesty how difficult! If the plan is meds then they should have given a prescription! I don’t think it is so difficult. 
We did find meds helpful here. 
All the best,
When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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sk8r31
Hoping that meds bring some relief and a bit more stability to the situation.  Hang in there!
It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou
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